A moral injury is when there is a traumatic or stressful situation, where someone fails to prevent, perpetrate, or witness something that is against their moral values or expectations. 

In short, a moral injury occurs as a response to witnessing or acting a certain behavior that goes against your morals, beliefs and individual values. 

Is this the same as PTSD?

About Moral Injury

When you do something that goes against your beliefs, this is an act of commission, and when you fail to do something that aligns with your beliefs, this is called an act of omission. Therefore, a moral injury occurs when the person feels like a great line has been crossed, or a transgression has occurred in relation to their morals. 

Examples of moral injury could be when civilians are called up to war, and have to perpetuate actions that go against their typical beliefs. They may fail to report something that goes against their ethics, or be part of violent acts that can cause a moral conflict. 

Symptoms of a moral injury often involve guilt, disgust, anger, irritability, shame, distress, and remorse. Someone with moral injury may also struggle with substance abuse to cope, or isolate themselves from others as they are ashamed, or unable to trust others. 

Because of the similarities here with PTSD, there is a lot of overlap between post-traumatic stress disorder and moral injury. But are they the same thing?

Is a Moral Injury the Same as PTSD?

Both a moral injury and PTSD can occur due to a life threatening, traumatic or harmful event to you or others. In addition, guilt and shame are the key symptoms of both PTSD and moral injury, as you may feel you have betrayed yourself, your morals, and others around you. 

While there are some overlapping symptoms to PTSD and moral injury, such as anger, depression, addiction struggles, and feelings of lowness, PTSD, and moral injuries are actually different from one another.

The main difference between a moral injury and PTSD is that post-traumatic stress disorder is a fear-based condition that may surface in various ways. Having a moral injury is based on your moral judgment, and having a moral injury depends on whether you have a working conscience or not.  

silhouette of a woman who is looking out at the waterIn contrast, PTSD can be more extreme in terms of symptoms. You can become hyper focused or aroused- panicking that something bad is going to happen again. These are again fear based reactions, whereas moral injury tends to be more guilt-based. 

That being said, someone can experience both PTSD and moral injury simultaneously, depending on what happened. 

How To Cope

Treating a moral injury can be different for everyone- as the situation may vary. It could be the fact that you have had to witness brutality in combat, and been unable to act at the time, or that as a doctor you’ve had to make difficult decisions due to staff and supply shortages. 

One of the most effective ways you can cope with feelings of guilt, shame or betrayal is to work on your self-talk. Instead of negative thoughts such as I should have done this, tell yourself you did the best you could under the circumstances and take what has happened as a life lesson. 

You need to accept what has happened, and try to take the positives out of a bad situation. You cannot change what has happened, but you can change how you think and feel about yourself. Be compassionate to yourself.  

It is also vital to gain support from friends and family, or to join a support group in your area. This can help you avoid negative coping mechanisms.

If you are struggling with moral injury or PTSD, it is essential you reach out to learn more about trauma therapy.